Skip to 0 minutes and 6 seconds So let me see if I’ve got this right. So you’ve been through a really hard time recently managing with your new baby. You said that you constantly feel tired, but you have trouble falling asleep at night. And you sometimes fall asleep during the day, but you become irritable with your baby if he wakes you. Also you’ve noticed your thoughts about having a baby have become quite negative and upsetting for you. And these difficulties have caused strain on your relationship with your partner, and you’re not seeing your friends and family very often. And your partner and family are worried about you. So can you tell me a bit more about these negative thoughts you’ve been having?
Skip to 0 minutes and 53 seconds I just keep having these horrible thoughts that maybe it’d be better if I didn’t wake up in the morning, or if I’d never had [? Saleem. ?] Are you still having thoughts like these? They haven’t changed much, really. I still get them when I go to bed at night. I just think about all the times that I’m going to have to get up. And it just sends my thoughts and mood just spiralling down. That must be quite disheartening for you to feel this way. So have you noticed any changes recently, for example, have the negative thoughts become more frequent or intense?
Skip to 1 minute and 39 seconds Not really. I just get them on the bad days when he just cries a lot or he won’t go down for a nap. OK. It sounds like these times can be tricky for you, but that most of the time you’re not having these thoughts or they aren’t intense. Is that right? Yeah. Yeah. I know that these thoughts can be uncomfortable and I appreciate your willingness to go over them. So let’s just keep an eye on them and see how they go. I mean, many people find that these types of feelings and thoughts improve as their mood improves. But sometimes, they can also be sticking or even get worse.
Skip to 2 minutes and 24 seconds So I’ll check in on this briefly at the beginning of our sessions. So should we focus now on what you did with the treatment over the last week?
Skip to 2 minutes and 36 seconds In the first treatment session, it is important to inform your client that each week you will check with her about how she is feeling in terms of risk and if there have been any changes in the way she has been feeling. Be sure to go over the following four values with your client and remind her to keep these things in mind as she progresses through the workbook. Time– remind your client to do the programme at a pace that works for her. Even a few minutes a day is great. Compassion– remind her to try to be kind to herself and to try to practise speaking to herself in a gentle and forgiving manner.
Skip to 3 minutes and 20 seconds Effectiveness– remind her that the course is not about doing things the right way or the wrong way. It’s about helping her to find strategies that work for her and help her. Curiosity– it can be easier for her to predict how things might go, either negatively or positively. Ask her to stay curious and open about what might happen.
Having asked your client about the impact of their current experience, it is recommended that you weave in the risk assessment at this point.
You should remind your client of the information gathered during the risk section of their initial assessment and enquire about any changes they may have noticed up to now.
Now watch the video of an example risk assessment between the therapist and her client.
This video talks you through the procedure of risk assessment. The included role play is a risk assessment that the therapist performs to evaluate how Tamala (the client) is feeling, and if there have been any changes recently in the way she has been experiencing PND.
Below are the four key points, discussed in the video, that you should remind the client of:
© University of Exeter